Preamble
The General Conference of the International Labour Organisation,
Having been convened at Montreal by the Governing Body of the International Labour Office and having met in its Twenty-ninth Session on 19 September 1946, and
Having decided upon the adoption of certain proposals with regard to the medical examination for fitness for employment of children and young persons, which is included in the third item on the agenda of the Session, and
Having adopted Conventions concerning medical examination for fitness for employment in industry and non-industrial occupations of children and young persons, and
Having decided to supplement these Conventions by a Recommendation,
adopts this ninth day of October of the year one thousand nine hundred and forty-six, the following Recommendation, which may be cited as the Medical Examination of Young Persons Recommendation, 1946:
Whereas the Medical Examination of Young Persons Conventions, 1946, lay down the basis for regulations relating to medical examination for fitness designed to protect the health of children and young persons against the risks of unsuitable employment but leave to national laws or regulations the choice of practical methods of detail; and
Whereas it is desirable, while permitting practical adaptations of the system of medical examinations so that it may be incorporated in the general administrative scheme of the various States Members, to assure reasonably uniform application of the Conventions for the purpose of maintaining at the highest possible level the protection of children and young persons which it is the aim of the Conventions to ensure; and
Whereas it is desirable to make known to all Members methods which have been found to give satisfactory results in certain countries and which may be a guide to them;
The Conference recommends that each Member should apply the following provisions as rapidly as national conditions allow and report to the International Labour Office as requested by the Governing Body concerning the measures taken to give effect thereto.
I. Scope of the Regulations
- 1. The provisions of the Medical Examination of Young Persons (Non-Industrial Occupations) Convention, 1946, should be applied to all occupations carried on in or in connection with the following undertakings and services, whether public or private:
- (a) commercial establishments, including delivery services;
- (b) postal and telecommunication services, including delivery services;
- (c) establishments and administrative services in which the persons employed are mainly engaged in clerical work;
- (d) newspaper undertakings (editing, distribution, delivery services and the sale of newspapers in the streets or in places to which the public have access);
- (e) hotels, boarding-houses, restaurants, clubs, cafés and other refreshment houses, and domestic service for wages in private households;
- (f) establishments for the treatment and care of the sick, infirm, or destitute and of orphans;
- (g) theatres and places of public entertainment;
- (h) itinerant trading, the hawking of objects of all kinds, and any other occupation or service carried on in the streets or in places to which the public have access;
- (i) all other jobs, occupations or services which are neither industrial nor agricultural nor maritime.
- 2. Without prejudice to the discretion which the Medical Examination of Young Persons (Non-Industrial Occupations) Convention, 1946, leaves to Members to exempt from its application employment, on work which is recognised as not being dangerous to the health of children and young persons, in family undertakings in which only parents and their children or wards are engaged, governments should, in taking into account the fact that occupations which are not generally considered hazardous may be dangerous for individuals who have not the aptitudes required for a certain job or for any job, endeavour to extend to all occupations carried on for profit, without consideration of the family relationship existing between the persons engaged in them, the application of the regulations concerning medical examination for fitness for employment.
II. Provisions Concerning Medical Examinations
- 3. Without prejudice to the medical examination on entry into employment for the purpose of certifying the fitness of a child or young person for a specified occupation required by Article 2 of the said Conventions, it is desirable that all children should undergo, preferably before the end of their compulsory school attendance, a general medical examination, the results of which can be used by the vocational guidance services.
- 4. The thorough medical examination required on entry into employment should-- (a) include all the clinical, radiological and laboratory tests useful for discovering fitness or unfitness for the employment in question; and
- (b) be accompanied in each case by appropriate advice on health care.
- 5. Periodical examination should--
- (a) be carried out in the same way as the examination on entry into a given employment; and
- (b) be accompanied by appropriate advice on health care and if necessary by supplementary vocational guidance with a view to a change of occupation.
- 6.
- (1) The findings of the examination should be entered in full on an index-card to be kept in the files of the medical services responsible for carrying out the examinations.
- (2) The information entered on the medical certificate intended to come to the knowledge of the employer or the statement concerning the medical examination endorsed on the permit or workbook should be explicit enough to indicate the limitations of fitness for employment noted in the examination and the precautions which should, as a result, be taken regarding employment conditions, but should on no account include confidential information such as the diagnosis of congenital defects or diseases discovered by the examination.
- 7.
- (1) Since in most cases the adolescent stage is not ended at eighteen years of age and there is consequently still need of special protection, it is desirable to extend compulsory medical examination until at least twenty-one years for all young workers employed in industrial or non-industrial occupations.
- (2) As a minimum, the degree of risk calling for the extension of medical examination until twenty-one years in accordance with Article 4 of the said Conventions should be estimated liberally; this extension should apply, in particular, to all mining occupations, to all employment in hospitals, and to such employments in public entertainment as dancing and acrobatics.
- 8. The provisions of the preceding paragraph should not be interpreted as impairing the obligation to apply the provisions of international Conventions or of national laws or regulations which prohibit the employment of young persons in certain occupations on account of the high health risks involved or which require, irrespective of the age of the worker, the health supervision of all those employed in such occupations.
III. Measures for Persons Found by Medical Examination to be Unfit or Only Partially Fit for Employment
- 9. The measures to be taken by the national authority for enforcing the provisions of Article 6 of the said Conventions should include, in particular, measures for ensuring that children and young persons found by medical examination to have physical handicaps or limitations or to be generally unfit for employment--
- (a) receive proper medical treatment for removing or alleviating their handicap or limitation;
- (b) are encouraged to return to school or are guided towards suitable occupations likely to be agreeable to them and within their capacity and are provided with opportunities of training for such occupations;
- (c) have the advantage of financial aid, if necessary, during the period of medical treatment, schooling or vocational training.
- 10. In order to facilitate the guidance towards suitable occupations of children and young persons found to be lacking in physical resistance or to have definite handicaps, it is desirable that lists of trades and occupations suitable to each category of young deficient or handicapped workers should be drawn up by qualified specialists under the joint responsibility of the medical services and the services competent to deal with employment problems; these lists should be used as guides for examining doctors but should not be binding.
IV. Responsible Authorities
- 11.
- (1) In order to ensure the full efficacy of the medical examination of young workers, measures should be taken to train a body of examining doctors who are qualified in industrial hygiene and have a wide experience of the medical problems relating to the health of children and young persons.
- (2) The competent authority should ensure that courses and practical studies are organised for this purpose.
- (3) Examining doctors should be selected on the basis of the qualifications indicated in subparagraph (1).
- 12. The system of medical examination for fitness for employment should be administered in such a way as to ensure close co-operation between the medical services responsible for carrying out the examinations and the services responsible for authorising the employment of children and young persons and for supervising their conditions of employment.
V. Methods of Enforcement
- 13.
- (1) In order to ensure a regular medical examination for fitness for employment to children and young persons employed in an industrial or non-industrial undertaking either on the premises of the undertaking or in connection with its operation, employers should be required to send to a specified authority a notification of the employment of all young workers under the age-limit laid down by the regulations for the examination.
- (2) This authority should be--
- (a) the official medical service responsible for carrying out the examinations and for keeping complete records of the findings of these examinations; or
- (b) the service competent to authorise the employment of a child or young person on the basis of the findings of the examination.
- 14. In order to ensure a regular medical examination for fitness for employment of children and young persons engaged, either on their own account or on account of their parents, in itinerant trading or any other occupation carried on in the streets or in places to which the public have access--
- (a) young itinerant workers under the age-limit up to which medical examination for fitness is compulsory should be required to obtain an individual licence, issued preferably by a service under the labour department on the basis of the certificate for fitness for employment and renewed annually on the basis of the findings of the annual re-examination; the licence should bear a serial number and the photograph or the signature or any other means of identification of the holder and should also include information concerning--
- (i) the name, age and address of the holder;
- (ii) the name and address of his parents and the statement that they have authorised the child or young person to engage in the occupation for which the licence is issued;
- (iii) the findings of the medical examination on entry into employment and of subsequent re-examinations;
- (b) the holder of the above-mentioned licence should be required to wear a visible badge bearing the serial number corresponding to that of the licence;
- (c) full co-operation should be established between the labour inspection services responsible for the enforcement of legislation and local authorities, particularly the services of the preventive police, for the purpose of checking regularly the documents of young itinerant workers and for ensuring their compliance with the regulations concerning medical examination for fitness for employment.
